Objective To seek better diagnostic tests for tuberculous pleural effusion. Methods Adenosine deaminase (ADA) and anti-TB antibody in pleural effusion were tested by modified Martineck’s method and ELISA in 50 cases of tuberculous pleural effusion, 45 cases of malignant pleural effusion and 30 cases of right cardiac insufficiency pleural effusion, respectively. Result The level of ADA and anti-TB antibody in pleural effusion remarkably higher in tuberculous pleural effusion than in malignant pleural effusion and right cardiac insufficiency pleural effusion (p<0.01). When ADA >45U/L and positive anti-TB antibody were present，their sensitivity, specificity and accuracy in diagnosis of tuberculous pleural effusion are 100%, 98.6%, 99.2% and 90% , 93.3%, 92%, respectively. Conclusion The tests of ADA and anti-TB antibody in pleural effusion are very important in diagnosis tuberculous pleural effusion.